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Changes in Cortisol Levels before and after Supportive Psychotherapy in Patients with Comorbid Cervical Cancer Distress with Depression Type Nuranna, Laila; Nuryanto, Kartiwa H; Andriansyah, Andriansyah; Elvira, Sylvia D; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 3 July 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To prove the success of supportive psychotherapy thatwas provided as a distress therapy on advanced cervical cancer.Knowing the prevalence of distress type of depression in patientwith epithelial cervical cancer, proving the benefits of psychotherapysupportive for distress can decreasing cortisol level in cervicalcancer patient, can assess distress thermometer score, HAM-D17score and scoring incident predictors of distress with depressiontype.Methods: There were 32 subjects from 71 advanced cervical cancerpatients had mild-moderate depression. Then randomizationblocking was performed to determine a subject who entered thetreatment group (n = 16) who got supportive psychotherapy orcontrol group who got common psychotherapy (n = 16). All ofparticipants assessed the distress level with cortisol value, distressthermometer score, and HAM-D17 score before and after they gotsupportive psychotherapy.Results: After the intervention of psychotherapy in the treatmentgroup decreased HAM-D17 score, the average decline 7.53 (SB 3.34).The mean decreasing in the control group was 3.98 (SB 2.85). Thereis a significant difference in mean reduction in HAM-D17 scores ontreatment and control groups with p = 0.003 (p <0.005). There wasdecreasing blood cortisol level in the treatment group amounted to39.43, while the control group there was a drop of 1.59. The reductionof cortisol level in the treatment group and the control has a pvalue0.302. After got supportive psychotherapy, found a decreasingthe average value of the thermometer distress in the treatmentgroup 3.02 and the control group 2.51, with a p value more than0.492.Conclusion: There were 45% of cervical cancer patients in the clinicexperiencing distress disorder with depressive type. The bloodcortisol level could be decreased by giving supportive psychotherapywith a mean decrease of 39.43 nmol/l. There was a significantreduction in the level of depression (HAM-D17 score) of 7.53 pointsand distress thermometer impairment by 3 points after givensupportive psychotherapy. Obtained scoring predictors for theoccurrence of distress type of depression in patients with advancedcervical cancer with a sensitivity of 46.15% and a specificity of89.47%.[Indones J Obstet Gynecol 2018; 6-3: 179-187]Keywords: cervical cancer, cortisol, distress, distress thermometer,HAM-D17 score

The Outcomes of Primary Debulking Surgery and Neoadjuvant Chemotherapy in Advanced Ovarian Cancer Rinaldy, Dino; Andrijono, Andrijono; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 2, April 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the outcomes and survival rate of primary debulking surgery with neoadjuvant chemotherapy. Method: We selected advanced ovarian cancer patients from medical records. Subjects were allocated into groups of primary debulking surgery and neoajuvant chemotherapy by considering the inclusion and exclusion criteria. We analyzed the data using T test, Fisher’s exact, and chi-square. The survival rate was presented in Kaplan Meier curve, whereas the significance was tested with Logrank. We managed the data using STRATA software version 12. Result: We obtained 32 cases of primary debulking surgery group and 20 cases of the neoadjuvant chemotherapy group. Most of the subjects (44.2%) were 40-49 years old and 80.8% had delivered more than twice. The mean value of Ca-125 at admission was 3,594.8 u/ml (range 66.6 to 73,000 u/ml). Total of 31 subjects showed the serous histologic type (59.6%). There was no association between primary debulking surgery and neoadjuvant chemotherapy for the parameter of operative time, blood loss, organs injury, ICU stay, and hospital stay (p>0.05). Primary debulking surgery had a survival rate similar to neoadjuvant chemotherapy group (p=0.95). Conclusion: The perioperative outcomes of advanced ovarian cancer patients has similar result between primary debulking surgery and neoadjuvant chemotherapy. Primary debulking surgery has a survival rate similar to neoadjuvant chemotherapy group. [Indones J Obstet Gynecol 2016; 4-2: 111-115] Keywords: advanced ovarian cancer, neoadjuvant chemotherapy, primary debulking surgery

Survival and Side Effects of Cisplatin/Cyclophosphamide and Carboplatin/Paclitaxel Adjuvant Chemotherapy in Stage IC-IV Ovarian Cancer Markus, Unedo H; Winarto, Hariyono; Andrijono, Andrijono; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the survival and side effects in epithelial ovarian cancer patients receiving adjuvant chemotherapy of cisplatin/ cyclophosphamide and carboplatin/paclitaxel. Method: We recruited epithelial ovarian cancer patients receiving cisplatin/cyclophosphamide (group A) or carboplatin/paclitaxel (group B) adjuvant chemotherapy after surgery. Chemotherapy was given for six cycles. Overall survival and side effects were assessed. Result: A total of 49 patients were recruited, consisting of 25 patients for group A and 24 patients for group B. In this study, the overall survival of stage IC-IV ovarian cancer patients was 37.3 months in group A (95%CI=31.86-43.46) and 35.5 months (95%CI= 13.93- 43.46) in group B (p

Treatment Response of PlatinumBased Chemoradiation on Locally Advanced Cervical Cancer Khonsa, Oni; Purbadi, Sigit; Supriana, Nana; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 4, October 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate the efficacy (treatment response), toxicity, and overall survival of concomitant chemoradiation (CRT) with three-weekly cisplatin-ifosfamide compared to CRT with weekly cisplatin in advanced stage cervical cancers (stage IIB-IIIB). Method: This is a historical cohort between 32 patients receiving CRT with three-weekly cisplatin and ifosfamide and 29 patients receiving weekly cisplatin in Gynecologic Oncology division outpatient clinic and ward, Dr. Cipto Mangunkusumo Hospital. Results: There was no significant difference in treatment response, overall and disease-free survival. There was more gastrointestinal toxicity in the cisplatin-ifosfamide arm compared to the other arm (p=0.014), but other toxicity effects were not different. Conclusion: Platinum based-chemoradiation has the same efficacy in terms of treatment response for locally advanced cervical cancer. [Indones J Obstet Gynecol 2015; 3-4: 212-221] Keywords: cisplatin, concomitant chemoradiation, ifosfamide, locally advance stage cervical cancer

Fascin Expression as Prognostic Factor for Survival in Advanced Epithelial Ovarian Carcinoma Vitantri, Fara; Purbadi, Sigit; Siregar, Budiningsih; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 4, October 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate fascin expression as a prognostic factor and its correlation with survival and clinicopathologic factors (degree of differentiation and stage) in epithelial ovarian carcinoma. Methods: This study is prognostic study with historical cohort design. Fascin was analyzed in paraffin block sections of 33 advanced stage ovarian carcinoma patients using immunohistochemistry. Fascin expression was tested for its correlation with overall survival as well as with grade and stage of the cancer. Results: In this study, fascin expression has no correlation with survival. In the period of 17-22 months, samples with high fascin expression had a HR of 1.59 (95% CI=0.38-6.67, p=0.449), but in the period of 17-23 months, both groups had comparable HR. In the period of more than 23 months, samples with high expression of fascin had a better HR of 0.40 (95% CI=0.04-4.38, p=0.449). No significant correlation was found between fascin expression with grade (OR=2.08, 95% CI=0.44-9.84, p=0.442) and stage (OR=2.70, 95% CI=0.39-18.96, p=0.360). Conclusion: In this study, there was no correlation between fascin expression and survival, and also no correlation between fascin, grade and stage. Further study with a larger, more homogenous sample, analyzing confounding factors is needed. [Indones J Obstet Gynecol 2015; 3-4: 222-229] Keywords: advanced stage ovarian carcinoma, fascin, survival

Survival and Side Effects of Cisplatin/Cyclophosphamide and Carboplatin/Paclitaxel Adjuvant Chemotherapy in Stage IC-IV Ovarian Cancer Markus, Unedo H; Winarto, Hariyono; Andrijono, Andrijono; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the survival and side effects in epithelial ovarian cancer patients receiving adjuvant chemotherapy of cisplatin/ cyclophosphamide and carboplatin/paclitaxel. Method: We recruited epithelial ovarian cancer patients receiving cisplatin/cyclophosphamide (group A) or carboplatin/paclitaxel (group B) adjuvant chemotherapy after surgery. Chemotherapy was given for six cycles. Overall survival and side effects were assessed. Result: A total of 49 patients were recruited, consisting of 25 patients for group A and 24 patients for group B. In this study, the overall survival of stage IC-IV ovarian cancer patients was 37.3 months in group A (95%CI=31.86-43.46) and 35.5 months (95%CI= 13.93- 43.46) in group B (p

Treatment Response of PlatinumBased Chemoradiation on Locally Advanced Cervical Cancer Khonsa, Oni; Purbadi, Sigit; Supriana, Nana; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 4, October 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate the efficacy (treatment response), toxicity, and overall survival of concomitant chemoradiation (CRT) with three-weekly cisplatin-ifosfamide compared to CRT with weekly cisplatin in advanced stage cervical cancers (stage IIB-IIIB). Method: This is a historical cohort between 32 patients receiving CRT with three-weekly cisplatin and ifosfamide and 29 patients receiving weekly cisplatin in Gynecologic Oncology division outpatient clinic and ward, Dr. Cipto Mangunkusumo Hospital. Results: There was no significant difference in treatment response, overall and disease-free survival. There was more gastrointestinal toxicity in the cisplatin-ifosfamide arm compared to the other arm (p=0.014), but other toxicity effects were not different. Conclusion: Platinum based-chemoradiation has the same efficacy in terms of treatment response for locally advanced cervical cancer. [Indones J Obstet Gynecol 2015; 3-4: 212-221] Keywords: cisplatin, concomitant chemoradiation, ifosfamide, locally advance stage cervical cancer

Fascin Expression as Prognostic Factor for Survival in Advanced Epithelial Ovarian Carcinoma Vitantri, Fara; Purbadi, Sigit; Siregar, Budiningsih; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 4, October 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate fascin expression as a prognostic factor and its correlation with survival and clinicopathologic factors (degree of differentiation and stage) in epithelial ovarian carcinoma. Methods: This study is prognostic study with historical cohort design. Fascin was analyzed in paraffin block sections of 33 advanced stage ovarian carcinoma patients using immunohistochemistry. Fascin expression was tested for its correlation with overall survival as well as with grade and stage of the cancer. Results: In this study, fascin expression has no correlation with survival. In the period of 17-22 months, samples with high fascin expression had a HR of 1.59 (95% CI=0.38-6.67, p=0.449), but in the period of 17-23 months, both groups had comparable HR. In the period of more than 23 months, samples with high expression of fascin had a better HR of 0.40 (95% CI=0.04-4.38, p=0.449). No significant correlation was found between fascin expression with grade (OR=2.08, 95% CI=0.44-9.84, p=0.442) and stage (OR=2.70, 95% CI=0.39-18.96, p=0.360). Conclusion: In this study, there was no correlation between fascin expression and survival, and also no correlation between fascin, grade and stage. Further study with a larger, more homogenous sample, analyzing confounding factors is needed. [Indones J Obstet Gynecol 2015; 3-4: 222-229] Keywords: advanced stage ovarian carcinoma, fascin, survival

The Outcomes of Primary Debulking Surgery and Neoadjuvant Chemotherapy in Advanced Ovarian Cancer Rinaldy, Dino; Andrijono, Andrijono; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 2, April 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the outcomes and survival rate of primary debulking surgery with neoadjuvant chemotherapy. Method: We selected advanced ovarian cancer patients from medical records. Subjects were allocated into groups of primary debulking surgery and neoajuvant chemotherapy by considering the inclusion and exclusion criteria. We analyzed the data using T test, Fisher’s exact, and chi-square. The survival rate was presented in Kaplan Meier curve, whereas the significance was tested with Logrank. We managed the data using STRATA software version 12. Result: We obtained 32 cases of primary debulking surgery group and 20 cases of the neoadjuvant chemotherapy group. Most of the subjects (44.2%) were 40-49 years old and 80.8% had delivered more than twice. The mean value of Ca-125 at admission was 3,594.8 u/ml (range 66.6 to 73,000 u/ml). Total of 31 subjects showed the serous histologic type (59.6%). There was no association between primary debulking surgery and neoadjuvant chemotherapy for the parameter of operative time, blood loss, organs injury, ICU stay, and hospital stay (p>0.05). Primary debulking surgery had a survival rate similar to neoadjuvant chemotherapy group (p=0.95). Conclusion: The perioperative outcomes of advanced ovarian cancer patients has similar result between primary debulking surgery and neoadjuvant chemotherapy. Primary debulking surgery has a survival rate similar to neoadjuvant chemotherapy group. [Indones J Obstet Gynecol 2016; 4-2: 111-115] Keywords: advanced ovarian cancer, neoadjuvant chemotherapy, primary debulking surgery

Caspase-3 can not be Used to Predict the Response to Neoadjuvant Chemotherapy Regiment PVB in Cervical Cancer Stage IB-IIA Ambari, Ediwibowo; Winarto, Hariyono; Sutrisna, Bambang; Siregar, Budiningsih
Indonesian Journal of Obstetrics and Gynecology Volume. 1, No. 3, July 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objectives: To determine the factors that may be used as the prognostic parameter for the therapeutic efficacy of neoadjuvant chemotherapy, which can be used to revising the management of early stage cervical cancer patients with large lesions. Methods: This was a retrospective cohort study. The study was conducted in the Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, University of Indonesia. The subjects were 15 cervical cancer stage IB2 and IIA patients with lesions’ size of > 4 cm, who would be treated with neoadjuvant chemotherapy, consisted of cisplatin 50 mg/m2, vincristine 2 mg/m2 and bleomycin 15 mg regiment. The patients’ response would be evaluated after completing 3 series of chemotherapy. Data was retrieved from medical records and cervical biopsy paraffin blocks and examined histopathologically using IHC staining to see expression of caspase-3 with histoscore assessment score. Data was analyzed by univariate, bivariate analysis. Results: Response to PVB neoadjuvant chemotherapy was found in 5 out of 15 patients. None of the clinicopathology variables can be used to predict response to therapy. Expression of caspase-3 as a marker of apoptosis, can not predict the response of the therapy before administrating neoadjuvant chemotherapy either. There is a significant difference between the levels of caspase-3 in epidermoid carcinoma with adenocarcinoma, with p value of 0.02 (RR 6;95% CI 1.69-21.26). Conclusion: Clinicopathologic factors and the expression of caspase-3 before getting chemotherapy neoadjuvant can not predict the succeed of the therapy. [Indones J Obstet Gynecol 2013; 1-3: 156-60] Keywords: caspase -3, clinicopathologic, early-stage cervical cancer lession in large, neoadjuvant chemotherapy response to therapy

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